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Organ Systems > Lipid digestion > Flashcards

Lipid digestion Flashcards

1
Q

What two peritoneal ligaments hold the liver between stomach and front abdominal wall?

A

Lesser omentum (between liver and stomach) and falciform ligament (between liver and front abdominal wall)

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2
Q

What are the 6 main liver functions?

A 
Macrophages
Metabolizes: carbs, lipids, proteins
Stores vitamins and iron
Fibroblast-like cells store vitamin A
Detoxifies drugs, hormones, bacterial metabolites
Secretes bile and conjugates bilirubin
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3
Q

What are the 4 blood pathways of the liver?

A

Hepatic artery - from heart to liver, O2
Hepatic vein - from liver to heart
Portal vein - from stomach, spleen, intestins to liver, no O2, nutrient-filled
Sinusoids - detox

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4
Q

What is in the portal area (triad) at each corner of a lobule of liver?

A

Hepatic artery
Portal vein
Bile canaliculus
(central vein runs through)

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5
Q

What is the liver acinus?

A

More function unit of liver
From hepatic and portal vessels:
Zone 1 with highest O2 and nutrients
Zone 3 with lowest but is where alcohol and drugs get detoxed (susceptible to toxic damage)

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6
Q

What is the lymphatic flow of plasma?

A

Sinusoids to space of Disse, located between hepatocytes and endothelium of sinusoids, then to inferior vena cava or thoracic duct

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7
Q

What can fibrosis lead to?

A

Portal hypertension

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8
Q

What is portal hypertension?

A

Back pressure of blood into portal circulation due to obstruction so varicose veins occur in places such as caput medusae (dilated abdominal veins)

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9
Q

What is ascites?

A

Excess lymph fluid build-up in peritoneal cavity from portal hypertension; drop in blood volume causes water retention
(liquid looks like beer because of albumin and can be extracted)

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10
Q

What’s in bile?

A

Bile acids/salts, phospholipids, cholesterol (end product is lecithin)
Electrolytes, melatonin (as antioxidant)

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11
Q

What are the biliary ducts?

A

R + L hepatic ducts, common hepatic duct, cystic duct, common bile duct
Main pancreatic duct
Hepatopancreatic ampulla (junction of common bile duct and pancreatic duct)
Major duodenal papilla (common bile and pancreatic juices going into duodenum)

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12
Q

What are gall bladder functions?

A

Store, concentrate, and release bile by relaxing spincter of Oddi

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13
Q

How can you determine if a patient has gallstones?

A

Abdominal ultrasound to look for sludge, gravel, stones

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14
Q

How can you determine if the gallbladder is contracting properly in response to CCK?

A

Do a scan to check for biliary dyskinesia anywhere above sphincter of Oddi

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15
Q

What does CCK do?

A

Promotes DIGESTION: gallbladder emptying, pancreatic secretion, intestinal peristalsis
Inhibits gastric emptying

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16
Q

What does secretin do?

A

Promotes HCO3 secretion from bile, pancreatic ducts, Brunner’s glands

17
Q

What are gall stones?

A

Precipitates of cholesterol

18
Q

What are gall stones caused by?

A

*Reduced reabsorption of bile salts in the terminal ileum
Excess absorption of water, bile salts, lecithin
Excess secretion of cholesterol
Inflammation of epithelium
Stasis of the gall bladder smooth muscle layer (increases cholesterol crystals)

19
Q

What is the triad of biliary lithogenicity?

A

Balance of %cholesterol, phosphatidylcholine (lecithin made from phospholipids), and bile salts

20
Q

What enzyme converts cholesterol to bile salts?

A

7-alpha-hydroxylase

21
Q

What 4 things require bile?

A

Digestion and absorption of lipids
Elimination of endogenous and exogenous substances
Neutralization of gastric acid
Bacteriocidal activity

22
Q

What is the sequence of fat digestion?

A

Lipases hydrolyze triglycerides into FFA
FFA transported to enterocytes via biliary micelles
FFA reconverted to TGs, then chylomicrons, then transported to blood through lacteal and thoracic duct

23
Q

What enzymes does bile use to emulsify fat?

A

Pancreatic lipase - breaks TG chains by hydrolysis
Phospholipase A2
Cholesterol esterase
*byproducts go into micelle

24
Q

Where is micelle conjugated and where is it deconjugated?

A

Conjugated to taurine or glycine to form bile salts in liver

Deconjugated in intestine by bacteria to form bile acids

25
Q

What do micelles transport?

A

Glycerides and FAs through mucosa

26
Q

What kind of FAs pass through the unstirred aqueous layer to reach enterocyte membrane but what kind goes straight to blood?

A

Long-chain FAs

Short and Medium-chain FAs

27
Q

What is the enterohepatic circulation of bile acids and salts?

A

They are recycled back to the liver
Reabsorption mostly occurs via active transport in the ileum
Bile salts (conjugated) and acids (deconjugated) are returned to liver and reconjugated to taurine and glycine

28
Q

Where are primary and secondary bile acids made respectively?

A

Primary - liver cholesterol

Secondary - intestinal flora

29
Q

What is bilirubin pigment conjugated with?

A

Glucuronic acid by enzyme UDP glucuronyl transferase

30
Q

What syndrome is caused by a deficiency of UDP glucuronyl transferase?

A

Gilbert’s syndrome - diagnose with blood test for bilirubin

31
Q

What do chylomicrons transport and where are they stored and made?

A

Long chain FAs and fat-soluble vitamins to blood via lacteals
Stored in liver and adipose tissue
Made in small intestine

32
Q

Where are VLDLs produced and what do they transport?

A

Liver mostly

TGs from liver to organs

33
Q

Where are LDLs produced and what do they transport?

A

In plasma
Cholesterol esters from liver to other tissues
*atherosclerosis

34
Q

Where is HDL made and what does it transport?

A

In plasma

Cholesterol from tissues to liver

35
Q

What is bilirubin derived from?

A

Hemoglobin

36
Q

What is bilirubin converted to by colonic bacteria?

A

Urobilirubin

37
Q

What is urobilirubin converted to to give feces its brown color or urine its yellow color?

A

Stercobilin

38
Q

What is jaundice?

A

Excess bilirubin from increased hemolysis, liver damage, or bile duct obstruction

Organ Systems (5 decks)

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